The American Board of Eye Surgery (the Board or ABES) distributes this Booklet of Information to all potential certification candidates. This publication explains the rules, regulations, and procedures governing the subspecialty certifications offered by the Board. Upon certification, certificate holders become bound by the Board’s then current Canons of Ethics (located in this document) and Rules and Regulations of the American Board of Eye Surgery.

This document supersedes all previous announcements of the Board concerning policies and procedures guiding the Board’s application, examination, and review process.

The Board reserves the right to alter its fees, policies, and procedures at any time, without issuing a new Booklet of Information. It cannot assume responsibility for giving advance notice of any changes. It is the responsibility of the candidate to obtain current information about certification procedures.

It is also the responsibility of the candidate to initiate the certification process by requesting an Application for Certificate from the Board office.

The Board will not be responsible for any opinion expressed concerning an individual’s credentials for certification unless it is in writing and over the signature of the President or Director of the Board.

The provisions of this publication are not to be construed as a contract between any candidate and the American Board of Eye Surgery.

All communications should be addressed to:

American Board of Eye Surgery

334 East Lake Road, #135

Palm Harbor, FL 34685-2427

Tel: 727.480.8542

Fax: 727.786.6622

E-mail: quality@aces-abes.org

Website: www.aces-abes.org

HISTORY OF THE BOARD

On July 20, 1985, ten noted ophthalmologists from throughout the United States met to discuss the growing concern for quality and quality assessment in eye surgery. From that initial meeting, the formal organization, the American Board of Eye Surgery, was established. On September 15, 1986, the American Board of Eye Surgery met all provisions of the District of Columbia’s Non-Profit Corporation Act and, accordingly, was issued a Certificate of Incorporation. On November 1, 1986, the Statement of Organization and Objectives were adopted, Officers were elected, and the American Board of Eye Surgery started functioning with this underlying purpose:

to organize and operate an objective, voluntary, peer based examination, assessment, and certification program for ophthalmic surgeons, to assist them in providing the highest quality ophthalmic surgical care to their patients, and to assure the excellence of such services to the purchaser, whether it be the patient or a third party carrier.

The purpose of the American Board of Eye Surgery is to address the need for subspecialty certification that permits all those concerned to recognize those ophthalmologists who have achieved or maintained a high level of surgical excellence, as measured by their peers. The Board does not attempt to limit surgical practice, but rather to promote, encourage, and enhance high-quality medical care.

The American Board of Eye Surgery wishes to uphold the highest quality of eye surgery in the examination of surgical preparation, performance, and results. Through evaluation of three areas preparation, performance, and results the Board not only identifies quality surgery, but helps all surgeons achieve the level of quality in these areas.

The Board is a not-for-profit organization, and the fees of candidates are used solely for reimbursement of actual expenses incurred during the examination process. The members of the Board serve without compensation.

Certification by the American Board of Eye Surgery signifies that the recipient has fulfilled the Board’s requirements in the recipient’s subspecialty area and is evidence that the recipient’s qualifications for subspecialty practice are recognized by his/her peers. Certification by the Board is not a requirement to practice eye surgery, and the Board does not confer, or purport to confer, any degree, legal qualifications, privileges, or license to practice. The Board does not in any way seek to interfere with, or to restrict, the professional activities of any duly licensed ophthalmologists because they are not Board-certified. Application for certification is purely voluntary.

Marketing activities which promote unrealistic expectations, minimize the magnitude and/or possible surgical risks, provide false or misleading information, and/or solicit patients for operations they might not otherwise consider is inconsistent with the high standards of professional and ethical behavior recognized by American Board of Eye Surgery Certification.

Issuance of a certificate only entitles the certificate-holder to represent that he/she is “Certified by the American Board of Eye Surgery” or “Certified in (e.g., cataract/lens implant surgery, refractive surgery, [RK and/or LASIK], penetrating keratoplasty surgery) by the American Board of Eye Surgery.”

The American Board of Eye Surgery disseminates the names of certified specialists where the Board of Directors deems necessary. The purpose of publicizing physicians who have been certified is to notify people that they have met the credentials of peer certification in the designated area of subspecialty surgery.

Certification by the American Board of Eye Surgery is valid for a period of seven years from the date of issuance of the certificate. In order to become recertified, the certificate-holder must comply with current recertification requirements.

Cataract/Lens Implant A specialist in cataract/lens implant surgery is a fully trained ophthalmologist who has acquired contemporary skills in the diagnosis and management of defects in the human lens and related ocular disorders, and who emphasizes and demonstrates these skills in his/her surgical practice. Optimally, such an individual will have completed at least three years of residency training in the surgical subspecialty of ophthalmology and must have successfully pursued certification by the American Board of Ophthalmology or the American Osteopathic Board of Ophthalmology.

Cornea – Keratoplasty The section of eye surgery that deals with the surgical correction of disease or trauma to the cornea. These individuals have been certified by the American Board of Ophthalmology or the American Osteopathic Board of Ophthalmology, and have training and experience to diagnose, treat, and operate on those individuals who have suffered injury or disease of the cornea. These physicians have particular knowledge and skills which enable them to serve as consultants to physicians who practice in other areas of medicine.

Refractive – Incisional Keratotomy and LASIK The section of eye surgery that deals with the surgical correction of refractive errors, including myopia, hyperopia, or astigmatism. These individuals have been certified by the American Board of Ophthalmology or the American Osteopathic Board of Ophthalmology, and have training and experience to diagnose, treat, and operate on those individuals who have refractive errors capable of being corrected by corneal surgery. These physicians have particular knowledge and skills which enable them to serve as consultants to physicians who practice in other areas of medicine.

Subspecialty certification are scheduled to be offered in the following areas:

Glaucoma A specialist in glaucoma is an ophthalmologist, who by virtue of additional education or special interest and self-training, is prepared to care for or consult patients with difficult glaucoma problems. This includes the wide range of glaucoma from congenital glaucoma, angle closure glaucoma, secondary glaucomas, and the more common open angle glaucomas. A glaucoma specialist’s practice is limited to glaucoma, or at least fifty percent of the patient load has glaucoma. The specialist will have been certified by the American Board of Ophthalmology or the American Osteopathic Board of Ophthalmology and should be an expert in all of the current diagnostic and treatment modalities used in the care of patients with glaucoma and keep abreast of new changes as they occur. This person should also consult on patients that are facing other procedures as to the preferred technique and possible effects of the procedure on the patients’ glaucoma.

Oculoplastic Oculoplastic surgery is the section of eye surgery that deals with the surgical correction of cosmetic or functional disorders of the external eye, lids, and adnexae. These individuals have been certified by the American Board of Ophthalmology or the American Osteopathic Board of Ophthalmology, and have training and experience to diagnose, treat, and operate on those individuals with congenital or acquired lesions of the eyelids or adnexae, or extraocular lesions, or problems of the lacrimal system, or cosmetic correction of the lids or adnexae. These physicians have particular knowledge and skills which enable them to serve as consultants to physicians who practice in other areas of medicine.

Retinal-Vitreous A retinal-vitreous surgeon is an American Board of Ophthalmology or American Osteopathic Board of Ophthalmology certified ophthalmologist that has had an additional fellowship (of at least one year) at a recognized retina-vitreous center. During this fellowship, the physicians have received the additional training in recognition, understanding, and surgical and/or laser treatment of diseases and injuries of the vitreous body and the retina, to qualify them to practice surgery of the retina and vitreous.

Strabismus Strabismology is that section of eye surgery that deals with the surgical correction of ocular muscle imbalance. These individuals have been certified by the American Board of Ophthalmology or the American Osteopathic Board of Ophthalmology, and have training and experience to diagnose, treat, and operate on those individuals with cosmetic or functional muscle imbalance of the eyes. These physicians have particular knowledge and skills which enable them to serve as consultants to physicians who practice in other areas of medicine.

The Board evaluates candidates through a multidimensional two-part approach. This certification process recognizes the importance of valid and accepted standards of quality for eye surgery. Part I, the application and records review, entails the following:

The candidate must submit an Application for Certificate containing information about his/her education, surgical practice, ethical behavior, professional behavior, and licensure/certification. (See page 6 for details.)

The candidate must record and submit specific data from consecutive surgical cases in his/her subspecialty area on the Operative Data Review Form in the applied-for subspecialty area. (See page 7 for details.)

A candidate is eligible for Part II of the certification process, the examination of surgical skill, if the application and operative data meet the Board’s required criteria. Part II entails the following:

The candidate must present the surgical records summarized on the Operative Data Review Form for audit.

The candidate must be observed performing surgical procedures in the applied-for subspecialty area by a trained on-site observer. The candidate must present the charts for these procedures as part of the observation.

The procedures observed must be videotaped and then evaluated by a panel of peers trained in evaluating videotaped procedures.

A certificate will be awarded to those candidates meeting all criteria established in connection with Parts I and II of the certification process.

All candidates for certification must meet the following basic requirements before submitting an application.

THE CANDIDATE MUST BE A GRADUATE OF AN AMERICAN BOARD OF OPHTHALMOLOGY OR AMERICAN OSTEOPATHIC BOARD OF OPHTHALMOLOGY APPROVED MEDICAL SCHOOL.

THE CANDIDATE MUST HOLD A CURRENT UNRESTRICTED LICENSE TO PRACTICE MEDICINE AND SURGERY in one of the states, districts, or territories of the United States or a province of Canada, or unrestricted privileges to practice medicine and surgery in the United States armed forces.

THE CANDIDATE MUST POSSESS HIGH MORAL, ETHICAL, AND PROFESSIONAL QUALIFICATIONS as determined by the Board.

THE CANDIDATE MUST BE CERTIFIED BY THE AMERICAN BOARD OF OPHTHALMOLOGY (ABO) OR THE AMERICAN OSTEOPATHIC BOARD OF OPHTHALMOLOGY (AOBO). The candidate must at all times continue to meet all requirements of the ABO OR THE AOBO. If the candidate is not currently certified, then the candidate must be certified within 2 years of completing the American Board of Eye Surgery (ABES) certification.

THE CANDIDATE MUST HAVE PERFORMED A SPECIFIED MINIMUM NUMBER OF SURGICAL PROCEDURES WITH FOLLOW-UP in the applied-for subspecialty area in the specified period preceding subspecialty application. The cases reported must be exclusive of procedures performed during the candidate’s residency and/or fellowship. The surgeries must meet specific criteria, as established by the Board.

THE CANDIDATE MUST COMMIT TO ACCUMULATING AT LEAST TWENTY (20) HOURS OF CONTINUING MEDICAL EDUCATION (CME) CREDITS IN THE APPLIED-FOR-SPECIALTY AREA EACH YEAR AFTER HE/SHE HAS BEEN CERTIFIED BY THE AMERICAN BOARD OF EYE SURGERY.

The following sections describe the procedures that must be followed during the application process. Any questions about the requirements or any portion of the application process should be directed to the Director’s office.

All candidates must use the Board’s official Application for Certificate, which may be obtained from the Board office. ALL APPLICATIONS MUST BE TYPEWRITTEN. All information must be accurate, current to date of submission (no projections), and complete.

The statement below, found on page 1 of the Application for Certificate, must be signed by the candidate.

I hereby apply to the American Board of Eye Surgery, for examination and certification in the subspecialty of _____________ (e.g., cataract/lens implant) surgery upon successfully completing the operative experience requirements and passing the examinations required by the Board, all in accordance with and subject to the rules and regulations of the aforesaid Board described in the Candidate’s Booklet of Information for Certification in Eye Surgery. I understand that certification issued will be valid for a limited time period. I agree to disqualification from examinations of surgical skill and from the issuance of a certificate of qualification, or to forfeiture and redelivery of such certificate to the Secretary of the Board, in the event that any of the statements hereinafter made by me are false or in the event that any of the rules governing such examinations are violated by me. I agree to hold said American Board of Eye Surgery, its members, examiners, officers, and agents, free from any damage or complaint by reason of any action they, or any of them, may take in connection with this application, such examinations of surgical skill, the evaluation made with respect to any of the surgical skill examinations, and/or the failure of said corporation to issue me such certificate. Upon the issuance of a certificate, I agree to and do become bound by the Rules and Regulations and the Canons of Ethics of the aforesaid Board, copies of which have been provided to me. Confidentiality. I also agree that the Board may release information, on an anonymous basis, obtained through the application process as may be required from time to time under the Rules and Regulations for compilation and evaluation in research and analysis by persons or organizations, and in accordance with procedures, approved by the Board. All information and responses contained in the application shall be subject to verification by the Board, as provided for in Rule 3.2 of the Rules and Regulations.

A check for the application fee payable in U.S. dollars to the American Board of Eye Surgery must accompany each application. See enclosed Fee Schedule for specific information regarding the fee for Part I of the certification process. No part of this application fee will be refunded under any circumstances.

Cataract/Lens Implant Subspecialty Requirements The Operative Data Review Form documents data from 50 consecutive cases with a minimum of three months of follow-up, exclusive of surgeries performed during the candidate’s residency and/or fellowship. Candidates are not to include combined cataract/glaucoma procedures, cataract/lens implant/PKP procedures (i.e., “triple cases”), secondary implants, or other combined procedures. The cases must reflect surgeries completed within the previous 24-month period. Information about the patient, preoperative data, operative data, initial postoperative data, last postoperative data, and secondary surgery is requested on the form.

Cornea – Keratoplasty Subspecialty Requirements The Operative Data Review Form documents data from 24 consecutive cases with a minimum of 12-months of follow-up, exclusive of surgeries performed during the candidate’s residency and/or fellowship. The cases must reflect surgeries completed within the previous 36-month period. Information about the patient, preoperative data, operative data, initial postoperative data, last postoperative data, and secondary surgery is requested on the form.

Refractive Subspecialty Requirements Incisional Keratotomy: The Operative Data Review Form documents data from 50 consecutive cases including at least 40 cases that are primarily treating astigmatism and/or myopia in otherwise normal eyes with a minimum of three months of follow-up after the last surgical procedure, exclusive of surgeries performed during the candidate’s residency and/or fellowship. Candidates are to document cases performed more than 12 months ago so as to permit up to 12 months of follow-up. The cases must reflect surgeries completed within the previous 24-month period. Information about the patient, preoperative data, operative data, initial postoperative data, last postoperative data, and secondary surgery is requested on the form.LASIK: The Operative Data Review Form documents data from 50 consecutive cases with a minimum of three months of follow-up after the last surgical procedure, exclusive of surgeries performed during the candidate’s residency and/or fellowship. Candidates are to document cases performed more than 12 months ago so as to permit up to 12 months of follow-up. The cases must reflect surgeries completed within the previous 18-month period. Information about the patient, preoperative data, operative data, initial postoperative data, last postoperative data, and secondary surgery is requested on the form.

ALL CASE DATA MUST BE TYPED OR CLEARLY PRINTED AND ACCURATELY IDENTIFIED. All data will be maintained as confidential. This data will be independently audited at the time of the on-site observation of eye surgery.

On page 1 of the Operative Data Review Form is a statement attesting to the accuracy of the reported data that the candidate must sign.

Decisions pertaining to fulfillment of requirements are made by the Board upon review of the candidate’s complete application packet and are governed by the Rules and Regulations in effect at that time. Consideration of a candidate will be delayed until all the requested information has been received by the Board, including the following:

completed and signed Authorization to Furnish Documents, Records, and Recommendations

The candidate must mail the completed and signed application, including the fee and all required data, to the Board office. Applications and related information become the property of the Board and will not be returned. The Board recommends retaining a photocopy of all submitted forms and supporting documents.

The Board’s decision about a candidate’s admissibility to the examination of surgical skill is governed by the policies and procedures in effect during the current application period. The Board reserves the right to cancel and/or reschedule observations under unusual circumstances. Appeal mechanisms are available to candidates who are denied the examination of surgical skill on the basis of reportedly unsatisfactory operative data or professional, moral, or ethical behavior.

Upon receipt of a completed application packet, including the Application for Certificate and Operative Data Review Form, the Board will take appropriate actions to certify and review the information submitted. Inquiry to the references named will be made concerning information relevant to the Board’s requirements for certification. The Board may also make additional inquiry, as necessary, to evaluate the candidate’s qualifications for examination.

In the course of its evaluation of the candidate’s professional practice, the Board will investigate circumstances related to:

the withdrawal, suspension, restriction, or relinquishment of the candidate’s license to practice;

actions pending before any state licensing board;

the restriction, relinquishment, withdrawal, or withholding of a candidate’s privileges to practice at any institution;

the limiting or curtailment of the candidate’s practice of eye surgery;

disciplinary action taken by any professional conduct, ethics, grievance, and/or quality review committee against a candidate;

a candidate convicted of a felony or currently under indictment for a felony;

a candidate addicted to the use of alcohol or legally controlled substances or receiving treatment for the abuse of, or addiction to, such substances; and

a candidate with malpractice actions presently pending or who has received an adverse legal decision in a malpractice suit, or who has settled a case for an amount in excess of $75,000.

If a candidate is found to be involved in litigation or investigation regarding ethical or moral issues, further review and/or action by the Board will be suspended until the investigation or legal action is concluded.

If the Board receives information which calls into question the standards of professional practice and/or ethical conduct of any candidate, that candidate will be notified in writing that the Board received such information. The candidate will then have an opportunity to explain, or respond to, the allegations. The Board will notify the candidate in writing of its decision and the reason(s) for it.

The data supplied on the Operative Data Review Form must meet the criteria established by the Board regarding information about the patient’s preoperative data, operative data, initial postoperative data, last postoperative data, and secondary surgeries.

Falsification of data or evidence of other egregious ethical, moral, or professional misbehavior will result in rejection of that candidate’s application.

Notification of Eligibility

Candidates will be notified in writing of their eligibility to undergo Part II of the certification process as promptly as is practicable. Notice will be sent to the candidate’s address on record. No information regarding the candidate’s credentials will be given over the telephone.

Candidates receiving written notification from the Board of their eligibility for the examination of surgical skill, Part II of the certification process, are required to pay an examination of surgical skill fee, payable to the Board in U.S. dollars. The candidate is also responsible for per diem and travel for the on-site observer and the cost of the videotaping and video technician (if applicable), including per diem and travel. See enclosed Fee Schedule for specific information regarding the fee schedule for Part II of the certification process for each subspecialty area.

Only after the Board receives the fee will arrangements be made for the observation and videotaping of the surgical procedures at the candidate’s usual place of surgery. An ABES observation coordinator will contact the candidate to schedule a convenient date for the examination of surgical skill.

Each candidate will be responsible for obtaining an individual and/or company to videotape the procedures. These videotapes will be collected by the on-site observer and used for the examination of the candidate’s surgical skill. Accordingly, it is vital that the videotapes be of high quality; inadequate-quality videotapes will not be reviewed and an additional on-site observation will have to be scheduled at the candidate’s own expense. To ensure the quality of the videotapes, the Board requires that one of the following methods be used when arranging the videotaping:

A candidate may use equipment that is part of the surgical suite provided the quality has been approved by the Board office. A sample videotape must be received by the office at least fifteen (15) days prior to the examination date. If the candidate is notified that the quality is acceptable, the surgical suite video equipment may be used. Alternately, a candidate may employ a video company and/or individual. In any case, the following requirements must be met:

The comprehensive portable video system must be able to fit into the surgery room without interfering with normal procedures. The system should be able to be set up and taken down in fifteen (15) minutes or less.

The camera must produce at least 400 lines of horizontal resolution and attach to the candidate’s operating room microscope.

The video recorder must produce at least 400 lines of horizontal resolution.

The TV monitor must allow the operator to check the camera focus and subject centering during the surgery to guarantee the quality of the final product.

The operator must have knowledge of eye surgery, and operating room principles, and meet the high professional and confidentiality ethics of the Board.

A candidate can request that the Board office furnish a videotape operator and equipment. The candidate is responsible for covering the actual cost of the operator and equipment, including all actual expenses. A deposit for these services must be received fifteen (15) days prior to the date of the examination.

The coordinator will also be able to answer questions pertaining to the arrangement and/or conduct of the audit, chart review, on-site observation, and videotaping.

The candidate will receive written notification of the date for the examination of surgical skill.

The data submitted on the Operative Data Review Form will be independently audited by the on-site observer at the time of the on-site observation. All records used to complete the form must be available to the on-site observer. Also, a member of the candidate’s staff should be available to assist the on-site observer in locating the relevant data.

Cataract/Lens Implant Three complete surgical procedures in the candidate’s applied-for subspecialty area must be observed as part of the examination of surgical skill. The on-site observer must observe the entire procedure from start to finish, including all preoperative and postoperative procedures.

Cornea – Keratoplasty A pre-determined specified number of complete surgical procedures in the candidate’s applied-for subspecialty area must be observed as part of the examination of surgical skill. The on-site observer must observe the entire procedure from start to finish, including all preoperative and postoperative procedures.

RefractiveIncisional Keratotomy: Six complete procedures (including 4 incisional keratotomies [one must include T cuts] and 2 enhancements) must be observed as part of the examination of surgical skill. The on-site observer must observe the entire procedure from start to finish, including all preoperative and postoperative procedures.LASIK: Five complete procedures and 1 enhancement must be observed as part of the examination of surgical skill. The on-site observer must observe the entire procedure from start to finish, including all preoperative and postoperative procedures.

After the completion of the examination of surgical skill, the candidate and the on-site observer must sign a form stating that the examination occurred on that date.

The candidate is required to submit a complete individual operative report on each patient observed by the on-site observer, along with a follow-up report including postoperative status, as required on the Operative Data Report Form.

The on-site observer will not provide the candidate, or anyone else in the facility, with information regarding the candidate’s performance on the examination of surgical skill.

The Board makes every effort to be as prompt as possible in notifying candidates of the results of the examination of surgical skill. Letters of notification will be sent by registered U.S. mail to the candidate’s address on record four (4) weeks after the receipt of the required follow-up data on the cases observed by the on-site observer.

A candidate who has been rejected on the basis of Part I, the application and records review, or has failed Part II, the examination of surgical skill, may initiate an appeal procedure by notifying the Director of the Board in writing. The Director must receive notification within sixty (60) days of the date of the Board’s notice informing the applicant of the Board’s action.

RE-EXAMINATION

Any candidate who does not meet the criteria for Part I, the application and records review, may reapply after a one-year (1) waiting period. The candidate must submit a new Application for Certificate and Operative Data Review Form in addition to the application fee in effect at the time of reapplication.

Any candidate who does not meet the Board’s criteria for Part II, the examination of surgical skill, may reapply. The candidate must inform the Board in writing of such intentions. If the Board receives such notification within one (1) year of the date of notification of eligibility for Part II, the candidate must submit an update to the Operative Data Review Form, and repeat the examination of surgical skill, all in accordance with the Board’s Rules and Regulations. The candidate must also pay all Part II fees in effect at the time.

For every two consecutive failures of the examination of surgical skill, the applicant must recommence the certification process as if no application had ever been received. However, if a candidate is disqualified by reason of conduct which calls into question the candidate’s standards of professional practice or ethical conduct, re-examination will be at the Board’s discretion.

ANNUAL REPORTING The Board shall have the right to periodically obtain from each certificate-holder data relating to the professional and surgical nature of the certificate-holder’s practice including, but not limited to, number of specialty-area surgeries performed during the year, follow-up data on the videotaped specialty-area procedures conducted in conjunction with Part II of the examination, and any pending or recent malpractice or disciplinary actions against the certificate-holder. The certificate-holder shall annually submit a record of 20 hours of CME in the specialty area(s) to assure continuing eligibility and compliance with the Rules and Regulations of the Board. The record of CME will be reviewed every three (3) years to ensure a cumulative total of 60 hours for each three (3) year period.

All certificate-holders must undergo a recertification process to continue to qualify for Board certification. The recertification includes, but is not necessarily limited to, the completion of all aspects of Part I of the initial certification process the application and the records review (Operative Data Review Form) in the appropriate relevant specialty area. In addition, the Board will audit a subset of cases documented in the Operative Data Review Form. See enclosed Fee Schedule for costs of recertification and the Rules and Regulations for further details regarding recertification.

REVOCATION OF CERTIFICATE All certificates issued by the Board are issued subject to the provisions of its Bylaws and Rules and Regulations of the American Board of Eye Surgery. The certificates are the property of the Board. The Board has authority to revoke any Board-issued certificate or to place a certificate-holder on probation for a fixed or indefinite time on the grounds summarized below.

The certificate-holder was not eligible to receive, or has since become ineligible to hold, the certificate, based on the rules and regulations currently governing the Board, whether or not the facts constituting such ineligibility were known or could have been ascertained by the Board at or before the issuance of the certificate.

The certificate-holder has violated any rule or regulation governing consideration for a certificate, at any time after the issuance of the certificate.

The certificate-holder has been found liable in, or has settled, one or more malpractice actions which, in the Board’s discretion, raise serious and substantial questions regarding the certificate-holder’s continued eligibility for certification by the Board.

The certificate-holder has failed to cooperate with the Board in any investigation undertaken pursuant to the Board’s Rules and Regulations.

The certificate-holder has violated the moral or ethical standards of the practice of medicine. The forfeiture, revocation, or suspension of physician’s license to practice medicine, or the expulsion from, or suspension from, the rights and privileges of membership in a local, regional, or national organization of his/her professional peers shall be evidence of a violation of such standards of the ethical practice of medicine.

The certificate-holder made any material misstatement or omission of fact to the Board in his/her application or other material presented to the Board, whether intentional or unintentional.

The certificate-holder has been convicted by a court of competent jurisdiction of any felony or misdemeanor involving moral turpitude and, in the opinion of the Board, having a material relationship to the practice of medicine.

The certificate-holder has used his/her certificate in a deceptive or misleading manner or otherwise has misrepresented the nature or purpose of the certification by the Board, including, but not limited to, any representation that his/her certificate applies to anyone or any entity other than the certificate-holder himself/herself, or has represented that certification by the Board entitles the certificate-holder to state any more than “Certified by the American Board of Eye Surgery” or “Certified in (e.g., cataract/lens implant, refractive surgery [RK and/or LASIK], cornea surgery) the American Board of Eye Surgery.”

The certificate-holder has failed to fulfill current continuing medical education requirements established by the Board.

The Board has sole discretion and authority to determine and decide whether or not the evidence or information placed before it is sufficient to constitute grounds for the revocation of any certificate issued by the Board.

When presented with probable cause to believe that a certificate-holder has engaged in unprofessional practice, the Board may investigate and gather facts concerning the possible existence of grounds for disqualification. If the Board obtains probable cause to believe that a certificate should be revoked for any of the reasons stated above, it may institute proceedings for revocation by mailing written notice to the certificate-holder that a hearing will be held. The notice will specify the ground(s) upon which a revocation proceeding is being instituted, and the date of the hearing. Notice will be sent by registered or certified mail to the last known address of the certificate-holder no less than thirty (30) days prior to the date of the hearing.

Upon revocation of a certificate, the holder is required to return his/her certificate and any other evidence of qualification to the Board and his/her name shall be removed from the list of certified specialists.

CHEMICAL DEPENDENCY A candidate who is otherwise qualified but who has had a history of chemical dependency which has not been under control for at least five (5) years will be eligible for certification only upon submission to the Board such information and documentation which establishes to the satisfaction of the Board that any history of chemical dependency has been under control for a period of time deemed reasonable in the sole discretion of the Board. The Executive Director shall specifically advise the Committee on Admissions, as set forth below, of the candidate’s request that such information and documentation, as may be supplemented by additional requests by the Executive Director, be accepted as demonstrating control of any prior chemical dependency. The Board may condition certification of a candidate with a history of chemical dependency upon submission of periodic reports documenting continued control of any prior chemical dependency for a period not to exceed five years from which such disease or condition is known to be under control.

All aspects of the Board certification process are strictly confidential. The information gathered during the application and records review and the examination of surgical skill are to be used only as part of the certification process, except as such information may be released on an anonymous basis for compilation and evaluation in research and analysis. All on-site observers are required to sign the following statement:

I will not discuss the results of this observation or share any information obtained in connection with my responsibilities as an American Board of Eye Surgery (ABES) on-site observer with the candidate or anyone other than an authorized ABES representative.

Every effort is made to ensure the anonymity of the candidate during the evaluation of the videotapes. All videotape examiners are required to sign the following statement:

I certify that I have no conflict of interest in regard to this candidate and no other personal or professional reasons for excusing myself from evaluating this candidate’s surgical performance as recorded on the accompanying videotape. I will not discuss the results of this observation or share any information obtained in connection with my responsibilities as an ABES videotape examiner with the candidate or anyone other than an authorized ABES representative.

The Board will endeavor to release certification results in a form that will protect the anonymity of the candidate. Unless authorized by the candidate, individual scores will otherwise be considered completely confidential.

All information gathered throughout the tenure of a certificate-holder’s certification is confidential, except as such information may be released on an anonymous basis for compilation and evaluation in research and analysis as authorized by the Board.

The contents of current and former candidate files are not available for review by anyone other than current Board members and authorized employees, except as such information may be released by the Board on an anonymous basis for compilation and evaluation in research and analysis as authorized by the Board or as may be required in connection with lawful judicial processes.

Principles of Ethics The Principles of Ethics listed below are aspirational and inspirational, as well as model standards of exemplary professional conduct for all applicants for certification and all ophthalmologists certified by the American Board of Eye Surgery (“ABES”). The term “ophthalmologists” as used herein shall include all such applicants and certificate-holders. The Principles of Ethics are not enforceable.

Canons of Ethics The Canons of Ethics listed below are mandatory and delineate specific standards of minimally-acceptable professional conduct for all ophthalmologists certified by ABES. The Canons of Ethics are enforceable; violation of any of them may serve as grounds for revocation or probation of ABES certification, pursuant to the Rules and Regulations.

Treatment of Patient The ophthalmologist must place the patient’s welfare and rights above all other considerations. The ophthalmologist must provide medical services with compassion, respect for human dignity, honesty and integrity.

Competence The ophthalmologist must maintain competence by continued study, supplemented by the opinions and talents of other professionals and with consultation when indicated.

Communication The ophthalmologist must maintain communication with the patient, or if the patient is unable to understand, with relatives and other authorized representatives of the patient. The ophthalmologist must safeguard patient confidences within the constraints of the law.

Fees The ophthalmologist’s fees must not exploit patients nor others who pay for services.

Discrimination The ophthalmologist must not discriminate in the delivery of professional services or in his/her employment of others on any basis that is unjustifiable or irrelevant, such as race, sex, age, or religion.

The ophthalmologist must be competent. An ophthalmologist is a physician who is educated and trained to provide medical and surgical care of the eyes and related structures. An ophthalmologist should perform only those procedures in which the ophthalmologist is competent by virtue of specific training or experience or assisted by one who is. An ophthalmologist must not misrepresent credentials, training, experience, ability or results. A physically, mentally or emotionally impaired ophthalmologist should withdraw from those aspects of practice affected by the impairment. If the ophthalmologist does not withdraw, it is the duty of other ophthalmologists who know of the impairment to take action to assure withdrawal of the impaired ophthalmologist.

The ophthalmologist must obtain informed consent from patients. The ophthalmologist may not perform medical or surgical procedures without appropriate informed consent of the patient or other authorized representative. The ophthalmologist also must obtain appropriate informed consent for any clinical experiments or investigative procedures to be conducted with patients.

The ophthalmologist shall obtain other opinions when appropriate. The ophthalmologist shall consult with other professionals where dictated by the patient’s condition. The ophthalmologist also shall obtain additional opinions of other professionals if requested by the patient.

The ophthalmologist shall adhere to specific standards of continuity of care. The ophthalmologist must have a policy that describes the extent of pre-operative, operative, and post-operative care he/she routinely provides. This should describe the routine and usual extent of care and must be explained in detail (as an informed consent) to each patient prior to scheduling of surgery.

Pre-operative examinations. The operating ophthalmologist must routinely perform pre-operative examinations on his/her patients. This examination shall include careful consideration of the patient’s physical, social, emotional and occupational needs. The operating ophthalmologist must examine the patient and assure that the pre-operative work-up accurately documents the ophthalmic findings and indications for surgery. The pre-operative examination must include a determination that surgery is necessary.

Post-operative examinations. It is the operating physician’s responsibility to provide the patient with quality post operative care, either directly or by an appropriately trained health care provider.

The ophthalmologist shall not prescribe or perform any medically unnecessary services. An ophthalmologist must order only those laboratory procedures, optical devices or pharmaceutical agents and must perform only those procedures that are in the best interest of the patient and that are medically necessary.

The ophthalmologist shall delegate services responsibly. Delegation of services is the use of auxiliary health care personnel to provide patient care for which the ophthalmologist is responsible. An ophthalmologist must not delegate to an auxiliary those aspects of eye care within the unique competence of the ophthalmologist (which do not include those permitted by law to be performed by auxiliaries). When other aspects of eye care for which the ophthalmologist is responsible are delegated to an auxiliary, the auxiliary must be qualified and adequately supervised. An ophthalmologist may make difference arrangements for the delegation of eye care and special circumstance, such as emergencies, if the patient’s welfare and rights are placed above all other considerations.

All communications to patients, the public, and colleagues must be truthful. An ophthalmologist’s communications to the public, patients and colleagues must be accurate and truthful. They must not convey false, untrue, deceptive, or misleading information through statements, testimonials, photographs, graphics, or other means. They must not omit material information without which the communications would be deceptive. Communications must not appeal to an individual’s anxiety in an excessive or unfair way, and they must not create unjustified expectations of results. If communications refer to benefits or other attributes of ophthalmic procedures that involve significant risks, realistic assessments of their safety and efficacy must also be included, as well as the availability of alternatives, and where necessary to avoid deception, descriptions and/or assessments of the benefits or to other attributes of those alternatives. Communications must not misrepresent an ophthalmologist’s credentials, training, experience or ability and must not contain material claims of superiority that cannot be substantiated. An ophthalmologist shall not represent that his/her Board certification applies to anyone or any entity other than himself/herself or that it entitles him/her to represent to the public any more than that he/she is “Certified by the American Board of Eye Surgery” or “Certified in (Cataract/Implant) Surgery by the American Board of Eye Surgery”. An ophthalmologist must not misrepresent the service that is performed or the charges made for that service.

An ophthalmologist must make appropriate disclosures. The ophthalmologist must disclose in communications to patients, the public, and colleagues any professionally-related commercial interests relevant to the ophthalmologist’s relationship to such individuals.

An ophthalmologist’s clinical judgment must not be impaired by economic interests. An ophthalmologist’s clinical judgment and practice must not be affected by economic interests in, commitment to, or benefit from professionally-related commercial enterprises.

An ophthalmologist must not accept or pay referral fees. Any form of financial reimbursement for referrals is strictly prohibited.

The Board is a not-for-profit organization, and the fees of candidates are used solely for reimbursement of actual expenses incurred during the examination process. The members of the Board serve without compensation.